SPEAKER_04

But with enough time and with enough variation, tumors will eventually evolve in a way—

that trick the immune system not only into not recognize them, but in fact to help them and feed them in a way to create an inflammatory environment that actually then the tumor uses to propagate its own cell division and then metastasis.

It's not so much a normal function.

It's a byproduct of what evolution is, that when the genes mutate when a cell divides or if you go out and, you know, stand in the sun too much, for instance, you get skin cancers because you're getting ionizing radiation that's changing the DNA, making a mutation.

And some of those random mutations will initiate a cancer.

So, for instance, I have a mutation called MIDFE318K.

It's a mutation that I was born with.

It wasn't in my family.

And it causes both melanoma and kidney cancer, which I've had both.

I've had a dozen melanomas alone.

We didn't find that out until a couple of years ago, but I've been following it over the years.

And we basically figured out, okay, it's going to have to be this.

So we had my genome sequenced.

But that's just one of hundreds of different kinds of mutations that can occur that are on a path towards creating a cancer.

But the cancer can't survive if the immune system recognizes it.

So eventually what happens is there's this detente that is reached between the immune system and the cancer where the immune system basically ignores the cancer.

So Jim Allison here in Houston won the Nobel Prize back in 2018.

for understanding one of these turn-off signals that the immune system, that the cancer is used to turn off the immune system, and that by showing he could block it, his wife, Pam Sharma, ran a bunch of clinical trials at MD Anderson that showed, in fact, that this could actually turn a 5% survival disease in melanoma to a 50% survival.

And that then created the whole immunotherapy field that the world is taking advantage of today.

So for instance, there are proteins on your cell surface, and we'll get too immunologically deep about it.